1. Field of the Invention
This invention relates to instruments for use in medical procedures. More particularly, this invention relates to a set of surgical instruments substantially for dissection and retraction in minimally invasive surgical procedures such as laparoscopy and mini-laparotomy.
2. Background Information
Surgical tools are commonly used in minimally invasive surgical procedures, such as mini-laparotomy, laparoscopic or thoracoscopic surgery, to provide mechanical handling of tissue. For example, during surgery on or adjacent to the spine the surgeon should have clear access to the desired intervertebral discs or vertebrae for purposes of discetomy, vertebrectomy, spinal decompression, or placement of fusion disc devices, prosthetics, or other hardware. Surgical tools may be used for dissection and/or retraction of blood vessels or other bodily tissues to provide clear access to the desired area. In some spinal procedures, the surgical entry point is on the abdominal side of the patient's body, so the tools must provide clearance so that the entire diameter of the abdominal cavity may be traversed for performance of the surgical procedure.
In some minimally invasive surgical procedures, such as laparoscopic or thoracoscopic procedures, one or more trocars typically penetrate and/or are maintained or mounted in the wall of the body cavity to provide access for the surgical tools during the procedure. The trocars may form or act as ports into the body cavity for insertion and manipulation of surgical instruments. Some surgical instruments, particularly those with sharp tips or edges, are inserted and moved to a desired working location in the body in hollow tubes or sheaths to reduce the risk of harming other blood vessels or organs during traversal of the body. A video camera may be mounted on a laparoscope which is passed through a trocar port for visualization of the procedures in the body cavity on a monitor. Alternatively, an X-ray or other visualization system may be used to view the procedure, including the position of instruments relative to the surgical site, on a suitable monitor.
Generally it is desirable to reduce the number of trocar ports used during a surgical procedure to reduce trauma to the patient. For this reason, a plurality of surgical tools, including tools dedicated to a specific function, adapted to be inserted through a trocar are preferred so that blood vessels, tissue, and the area of the surgical procedure may be manipulated through a small number of trocar ports or through a mini-laparotomy incision.
A variety of tools, such as retractors, forceps, graspers, suture needles, and pins, currently exist and may be available for use during abdominal or thoracic procedures. Such tools, however, have certain deficiencies when mninimally invasive access methods are used. One problem with available surgical tools is that they are not properly shaped for optimal harmless manipulation of blood vessels and other bodily tissue during laparoscopic or thoracoscopic procedures. Another problem with some surgical tools which might be appropriately shaped is that they do not fit through the tubes or trocars, so it can be difficult to traverse the body to reach the desired working location. The typical trocar is approximately 11 to 12 or less millimeters in diameter, and the hollow tubes therein are of approximately the same diameter. Some surgical tools have working ends of greater than 12 millimeters in length, and it would be difficult or impossible to insert these tools through typical trocars and tubes.
A need exists for surgical tools and methods which reduce potential trauma associated with surgery, including minimally invasive surgical procedures, and which aid the surgeon in manipulating blood vessels and tissue during surgical procedures. More specifically, a need exists for surgical tools for dissection and retraction that are shaped to allow a surgeon to manipulate blood vessels and other bodily tissue without harming the patient. The tools should also be properly shaped to perform specific functions or procedures conveniently and with minimal risk to the patient, yet they should be usable through typical trocars, ports or short incisions (e.g., incisions of the type used in mini-laparotomy).